在一个单一的第三级护理中心中,孕产妇的心脏病和产周期结局
Juan M Gonzalez1, Ian Harris2, Norma Jimenez Ramirez3
1Division of Maternal-Fetal Medicine and Perinatal Genetics, Department of Obstetrics and Gynecology, University of California San Francisco, San Francisco, CA, USA.
概括
母亲心脏病显著增加了不良妊娠结果的风险,包括早产和子宫内生长限制. 对这些高风险怀孕的最佳护理需要涉及专家的多学科方法.
科学领域:
- 心脏病学 心脏病学
- 产科 产科 产科 产科 产科
- 新生儿科学 新生儿科学
背景情况:
- 美国的孕产妇死亡率正在上升,心脏病是其中的主要原因.
- 改善的儿科存活率导致更多患有先天性心脏病的妇女达到生育年龄,增加高风险的产科人口.
研究的目的:
- 为了评估产科和新生儿结局在怀孕并发症的母亲心脏病 (获得和先天性) 的怀孕.
主要方法:
- 从2008年至2013年间9026次分娩的回顾性队列研究.
- 在未暴露妊娠和患有母性心脏病 (获得或先天性) 或仅先天性心脏病的孕妇之间比较结果.
- 使用后勤和线性回归分析,控制混因子 (p < .05).
主要成果:
- 母亲心脏病与早产,子宫内生长限制 (IUGR),辅助性阴道分娩,ICU入院和长时间住院的可能性增加有关.
- 新生儿结局显示,怀孕年龄小 (SGA) 和低Apgar分数的几率增加.
- 先天性心脏病亚组分析显示,早产,辅助分娩和住院治疗的趋势相似,SGA是新生儿显著的结果.
结论:
- 孕妇患有母性心脏病 (既得或先天性) 的怀孕显示出显著增加的不良围产期结局.
- 涉及母胎医学,心脏病学,产科麻醉和辅助支持的多学科方法对于管理这种高风险人群至关重要.
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